Prevalence, clinical characteristics, and predictors of sleep disordered breathing in hospitalized heart failure patients

Abstract

Background: Heart failure (HF) is often comorbid with sleep disordered breathing (SDB). This prospective study investigated the prevalence, clinical characteristics, and predictors of SDB in hospitalized HF patients. Methods: Sleep studies were performed on hospitalized HF patients from January 2015 to February 2019. SDB was categorized as no/mild SDB, obstructive sleep apnea (OSA), and central sleep apnea (CSA). Results: The study included 1069 hospitalized HF patients. The prevalence rates of OSA and CSA were 16.6% and 36.9%, respectively. Patients with OSA or CSA were more likely to be male and have a higher body mass index (BMI) and more comorbidities. Multivariate logistic regression analysis showed that male sex (odds ratio [OR] = 1.803, 95% confidence interval [CI] = 1.099–2.958), BMI (per 5 kg/m2 increase: OR = 2.270, 95% CI = 1.852–2.783), hypertension (OR = 2.719, 95% CI = 1.817–4.070), diabetes (OR = 1.477, 95% CI = 1.020–2.139), and left ventricular ejection fraction (LVEF) (per 5% increase, OR = 1.126, 95% CI = 1.053–1.204) were independent predictors of OSA. Male sex (OR = 1.699, 95% CI = 1.085–1.271), age (per 10 years, OR = 1.235, 95% CI = 1.118-1.363), heart rate (per 10 bpm, OR = 1.174, 95% CI = 1.099–2.958), LVEF (per 5% increase, OR = 0.882, 95% CI = 0.835–0.932), NT-proBNP (lnNT-proBNP, OR = 1.234, 95% CI = 1.089–1.398) and hypocapnia (OR = 1.455, 95% CI = 1.105–1.915) were independent predictors of CSA. The areas under the receiver operating characteristic curves were 0.794 (95% CI = 0.758–0.830) and 0.673 (95% CI = 0.640–0.706), respectively. Conclusions: More than half of hospitalized HF patients had OSA or CSA, and CSA was the predominant type. OSA and CSA predictors differ. The clinical characteristics of HF patients can help make preliminary predictions for SDB patients.